Application

Applications for Medicaid are made through the Department of Children and Families (DCF). Call the toll-free number (866) 762-2237 or visit http://www.myflorida.com/accessflorida/.

A person who moves here from another state, who had Medicaid in the prior state, has to apply for Medicaid in Florida. People who receive Supplemental Security Income (SSI) should contact Social Security to report their new address when they move into or out of Florida. Call Social Security’s toll-free number (800) 772-1213 or TTY (800) 325-0778, or visit www.ssa.gov.

Families who only want to apply for Medicaid for their children may submit a Florida KidCare application. Call the toll-free number (888) 540-5437 or TTY (877) 316-8748 or visit www.floridakidcare.org.

Choosing a Medicaid Managed Care Plan

Medicaid recipients who qualify and become enrolled in the Managed Medical Assistance (MMA) Program, will receive all health care services (other than long-term care) from a managed care plan. Your eligibility to enroll in the MMA program provides you the opportunity to choose among the plans in your area of the state and to receive services from providers who are a part of the plan. A choice counselor will help you pick the plan in your region that best meets your needs. When it is time for you to select a plan, you can contact a choice counselor. Use your computer and go to www.flmedicaidmanagedcare.com or call 1-877-711-3662 to talk to a choice counselor.

Discontinue Medicaid Enrollment

To stop Medicaid coverage you need to contact the DCF. Within Florida call the toll-free number (866) 762-2237 or from outside of Florida, write to the DCF mail center at ACCESS Central Mail Center, P.O. Box 1770, Ocala, FL 34478-1770.

Eligibility

Three basic groups are eligible for Medicaid, if they meet specific income and asset requirements:

• Children and families, including pregnant women
• Recipients of Supplemental Security Income
• Seniors (age 65 or older) and people who are blind or have a disability

To find out if a person is eligible, submit an application to the Department of Children and Families. For more information visit http://www.myflorida.com/accessflorida/.

Find Medicaid Doctors, Dentists & Specialists

If you are enrolled in a managed care plan, please contact your plan for a list of network providers.

Medicaid and Medicare

Medicaid and Medicare are two separate programs. Medicaid is a program for certain groups of people whose income and assets qualify them for help with their medical care. Medicaid programs can vary from state-to-state. Medicare is a federal health insurance program for people who are age 65 or older, people with disabilities, or those with end-stage kidney disease. Medicare eligibility is not based on income, and basic coverage is the same in each state.

For questions about Medicare, call the toll-free number (800) 633-4227 or TTY (877) 486-2048 or visit www.Medicare.gov.

If a person is covered by both Medicare and Medicaid, the Florida Medicaid program may cover:

• Medicare deductible (what a person pays before Medicare starts to pay for covered services);
• A portion of Medicare co-payment and co-insurance (the cost a person shares with Medicare for some covered services);
• Premiums paid for Medicare coverage; and/or
• Some services or items Medicare does not cover (up to the amount Medicaid will cover).

If a person receives Medicare only, they may still be eligible for help with the above expenses through the following programs: Qualified Medicare Beneficiaries (QMB), Qualifying Individuals 1 (QI-1), and Special Low-Income Medicare Beneficiaries (SLMB). To apply for one of these programs call the Department of Children and Families’ toll-free number (866) 762-2237 or visit http://www.myflorida.com/accessflorida/.

Medicaid Card

The Department of Children and Families provides Medicaid cards. For a replacement card, call the toll-free number (866) 762-2237.

If you were just approved for Medicaid it can take two to three weeks to receive the card. To request a replacement card, call 1-866-762-2237. Those on Medicaid can print a temporary Medicaid card from their MyACCESS Account.

Medicaid Field Offices

If you are a recipient or provider who needs assistance from the Medicaid Beneficiary Services Unit with a non eligibility related issue, you may call (877) 254-1055 during normal working hours.

Medicaid Providers

Sign Up for Medicaid Health Care Alerts – Receive email notification of Medicaid policy clarifications and other health care information appropriate for your selected provider type. Also for additional provider information visit ahca.myflorida.com/Medicaid.

Medicaid Services

The type and amount of services Medicaid covers depends on the age of the beneficiary, the type of Medicaid program in which the recipient is enrolled, and the type of services that are medically necessary. Medicaid services may include: doctor, hospital, family planning (birth control, pregnancy and birth care), home health care, nursing home, hospice, transportation, dental and visual, prescription drugs, community behavioral health, and other types of services. For more information, visit http://ahca.myflorida.com/Medicaid/index.shtml.

Refugee Assistance Program and Emergency Medicaid for Aliens

Refugee Assistance Program: This refugee program is funded through the U.S. Department of Health and Human Services, and provides short-term Medicaid for those who qualify. The Department of Children & Families oversees Refugee Services. To learn more visit www.myflfamilies.com/service-programs/refugee-services .

Emergency Medicaid for Aliens: Noncitizens, who are Medicaid eligible except for citizenship, may be eligible for Medicaid to cover a serious medical emergency. It covers only the medical emergency. Noncitizens who are tourists or are here for business are not eligible. Applications are taken at the Dept. of Children and Families. For more information visit the DCF website (www.myflfamilies.com/) or call the toll-free number (866) 762-2237.

Report a Statewide Medicaid Managed Care Program Issue (File a Complaint)

If you have an issue with a Medicaid managed care plan that you need help resolving (e.g., delayed authorization or payment, etc.), please inform us as soon as possible so the issue can be handled in an expedited manner. You can submit a complaint through our website at https://apps.ahca.myflorida.com/smmc_cirts/ or you may call and speak with a Medicaid representative toll free at 1-877-254-1055; Telecommunications device for the deaf (TDD) 1-866-467-4970.

Statewide Medicaid Managed Care Program

The Agency has a comprehensive website for Medicaid recipients, providers, plans, and other interested stakeholders. You can access this site by clicking on the following link: http://ahca.myflorida.com/SMMC

Termination, Denial or Reduction Appeal

You have the right to appeal any decision made about your Medicaid application or any reduction or termination of your benefits. You can request a hearing by telephone at (850) 488-1429, by Fax at (850) 487-0662, in writing at Department of Children and Families, Office of Appeal Hearings, Building 5, Room 255, 1317 Winewood Boulevard, Tallahassee, FL 32399-0700 and by email at appeal.hearings@myflfamilies.com.